Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Capacity vs. Willingness

If you have someone who is fully recovered, who seems to be honest, but who passively blocks all efforts to return him to work, the first consideration is financial status.

While people initially are deeply concerned about the reduction of their income from full salary to disability benefits, families adapt. The spouse goes to work, they sell off extra possessions, they _belt-tighten_ and they begin to adjust to their new financial base.

As months, and sometimes years, pass, their sense of connection to their job (which may never have been a career in the first place_just a means of making money) has emotionally ended. They cease to feel the urgency each day to return to work_an urgency that was burning within them when first injured.

They know that once a week, a tax-free check will arrive, and during the week, they can relax and have virtually no responsibility.

While this is most common in those over fifty years of age, you do see it in injured young adults as well.

Your first concern, therefore, should be: _Does the patient and his family any longer need him to work?_ If the answer is _no,_ you will not be successful in motivating him to return to any form of employment. You will have to consider some form of closure.

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